Evaluation of the Use of Guidelines

What to know

This Research Guide includes open access examples of different ways to evaluate the use of guidelines from a variety of authors. The materials are organized according to the focus of the evaluation.

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About the research guide

Authors: Melissa Jennings and Goldie MacDonald.

This Research Guide includes open access examples of different ways to evaluate the use of guidelines from a variety of authors in clinical, public health, and laboratory settings. The World Health Organization defines guidelines as documents that contain recommendations about interventions used in clinical and public health policy or practice.12

The materials are organized according to the focus of the evaluation: attitudes or knowledge related to adherence to guidelines; factors that facilitate or hinder the implementation of guidelines; differences in how health care providers use guidelines; clinician adherence to guidelines; adherence to laboratory and clinical guidelines; and adherence to guidelines among specific populations. The last section includes approaches, methods, or tools that can be applied to evaluate guidelines use. The authors completed a detailed literature search and reviewed candidate items according to predetermined criteria.

Examine attitudes or knowledge related to adherence to guidelines

  • Allen, Jennifer, D., Bluethmann, S. M., Sheets, M., Opdyke, K. M., Gates-Ferris, K., Hurlbert, M., Harden, E. (2013). BMC Public Health. 13(1), 1169. doi:10.1186/1471-2458-13-1169
  • Breimaier, Helga E., Halfens, R. J., Lohrmann, C. J. BMC Nursing. (2015). 14(1), 18. doi:10.1186/s12912-015-0064-z
  • Bornstein, Marta., Ahmed, F., Barrow, R., Risley, J. F., Simmons, S., Workowski, K. A. (2017). Sexually transmitted diseases. 44(1), 13-16. doi:10.1097/olq.0000000000000542

Examine factors that facilitate or hinder the implementation of guidelines

  • Gray, Amy Z., Soukaloun, D., Soumphonphakdy, B. (2017). Am J Trop Med Hyg. 97(2), 602-610. doi:10.4269/ajtmh.16-1005
  • Schachter, Kenneth A., Cohen, S. J. (2005). Prev Chronic Dis. 2(1), A17.
  • Barker, Anna. (2013). The Centre of Research Excellence in Patient Safety (CRE-PS), School of Public Health and Preventive Medicine, Monash University.

Examine differences in how health care providers use guidelines

  • Hartmann, Eugenie. E., Bradford, G. E., Chaplin, P. K. N., Johnson, T., Kemper, A. R., Kim, S., Marsh-Tootle, W. (2006). American Acadamy of Pediatrics. 117(2), e226-e237. doi:10.1542/peds.2004-2809
  • Lee, Ping Yein., Liew, S. M., Abdullah, A., Abdullah, N., Ng, C. J., Hanafi, N. S., Chia, C. Y., Lai, P. S. M., Wong, S. S. L., Khoo, E. M. (2015). PLoS ONE. 10(5). doi:10.1371/journal.pone.0126191
  • Mueller, Yolanda., D'Acremont, V., Ambresin, A. E., Rossi, I., Martin, O., Burnand, B., Genton, B. (2014). J Travel Med. 21(3), 169-182. doi:10.1111/jtm.12099

Examine clinician adherence to guidelines

  • Mathews, Robin., Chen, A., Thomas, L., Wang, T., Chin, C. T., Thomas, K., Roe, Matthew T., Peterson, E. American Heart Association. (2014). Circulation, 130(8), 659-667. doi:10.1161/CIRCULATIONAHA.113.008370
  • Cloutier, Michelle M., Salo, P. M., Akinbami, L. J., Cohn, R. D., Wilkerson, J. C., Diette, G. B., Williams, S., Elward, K., Mazurek J., Spinner J. R., Mitchell T., Zeldin, D. C. (2018). J Allergy Clin Immunol Pract. 6(3):886-894.e4, 6(3).
  • Bohnert, Amy S. B., Guy, G. P. Jr., Losby, J. L. (2018). Ann Intern Med. 169(6), 367-375. doi:10.7326/m18-1243

Examine adherence to laboratory and clinical guidelines

  • Fitzgibbons, P. L., Goldsmith, J. D., Souers, R. J., Fatheree, L. A., Volmar, K. E., Stuart, L. N., Nowak, J., Astles, R., Nakhleh, R. E. (2017). Arch Pathol Lab Med, 141(9), 1247-1254. doi:10.5858/arpa.2016-0558-CP
  • Jerome, Scott. S. D., Tilkemeier, P. L., Farrell, M. B., Shaw, L. J. The American College of Cardiology. (2015).
  • Melia, Juliette., Coulson, P., Coleman, D., Moss, S. (2008). British Journal of Cancer. 98(7), 1176-1181. doi:10.1038/sj.bjc.6604291

Examine trends in adherence to guidelines among specific populations

  • Hirth, Jacqueline. M., Laz, T. H., Rahman, M., Berenson, A. B. (2016). J Womens Health (Larchmt). 25(4), 371-380. doi:10.1089/jwh.2015.5270
  • Woodring, Joseph., V. D., Kruszon-Moran, D., Oster, A. M., McQuillan, G. M. (2014). JAIDS Journal of Acquired Immune Deficiency Syndromes.
  • Xu, X., McDermott, S. W., Mann, J. R., Hardin, J. W., Deroche, C. B., Carroll, D. D., Courtney-Long, E. A. (2017). Prev Med. 100:167-172., 100.

Examples of approaches, methods, or tools to evaluate guidelines use

  • Glasgow, R. (n.d.). Month: September 1999. Retrieved August 6, 2019.
  • Kashyap, N. (2011). Retrieved August 1, 2019, from
  • Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., Lowery, J. C. (2009). Implementation Science, 4(1), 50. doi:10.1186/1748-5908-4-50

Author affiliations and disclaimer

Author affiliations:

Melissa Jennings is a Public Health Analyst in the Division of Laboratory Systems; Center for Surveillance, Epidemiology, and Laboratory Services; Centers for Disease Control and Prevention; Atlanta, GA, USA

Goldie MacDonald is the Associate Director for Evaluation in the Center for Surveillance, Epidemiology, and Laboratory Services; Centers for Disease Control and Prevention; Atlanta, GA, USA

Disclaimer:

The findings and conclusions in this guide are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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  1. WHO Handbook for Guideline Development. (Handbook). (2012). Geneva: World Health Organization.
  2. WHO Handbook for Guideline Development – 2nd ed. (Handbook). (2014). Geneva: World Health Organization.